Is Botox Dangerous

When people are just starting to get Botox treatments one of their legitimate concerns that they express to me is, can the Botox travel to other parts of their body and cause something dangerous? Or act in a place that we don’t want it to act? And I’m happy to tell you the answer is, No. When Botox is injected into the skin or into the muscle, the two most common places where it is injected, it’s almost immediately absorbed onto the surface of nerves. There’s a great chemical attraction between the Botox molecule and the outside lining of the nerves. Once it’s attracted there and absorbed onto the outside of the nerve, thru chemical processes it then goes inside the nerve and that’s irreversible. It can’t then go out of the nerve and go somewhere else. That binding occurs within an hour, within an hour and a half of the time the medicine is injected and at that point the Botox just can’t do anything else. By the way, the way the Botox works is by being inside that nerve, it then stops the nerve that are releasing the chemicals that are the messengers that go to the muscle and tell the muscle to contract. So if the nerve can’t release those messengers then the muscle can’t contract and that’s how the Botox does for you what you want it to do. Well, then some people take that issue to an extreme and say, what happens, if in the course of the injection instead of the Botox going to the skin or into the muscle, it actually goes into a blood vessel? Certainly if it goes into a blood vessel then it can travel to other parts of the body, and that’s true. But please understand, most injections of Botox are no more than 4 or 5 units of Botox. Sure, in the course of a facial treatment you may get a total from 20 to 75 units, but no more than 4 or 5 units in an injection. In order for the Botox to do damage in your bloodstream where it’s distributed throughout your entire body, you’d have to have thousands and thousands of units of Botox, not 5 units. So let me give you every reassurance. Botox is not dangerous; it can’t spread to other parts of your body and if you have a Botox treatment enjoy what it does for you and enjoy how it makes you look better.

Botox is extremely effective at helping to remove and prevent lines and wrinkles. However, many people are concerned about it's safety. In this episode of DermTV, Dr. Schultz explains why Botox when administered by a professional is perfectly safe.

But here are some very real side effects from the official Botox Website.

• Droopy eyelids -- in up﻿ to 3 percent of people

• Nausea -- up to 3 percent

• Muscle weakness -- up to 2 percent

• Facial pain -- up to 2 percent

• Indigestion or heartburn -- up to 1 percent

• Tooth problems -- up to 1 percent

• High blood pressure (hypertension) -- up to 1 percent

Neal Schultz, M.D. on August 5, 2010 at 3:49pm

@anthony: Thank you for posting those. I think they're very important for people who are considering Botox to see. However, I believe it's also very important to understand those statistics. So let's put them into perspective in two different ways. (As a side note, discussions such as this one is exactly why I started DermTV: to separate the facts from the noise/misinformation out there.)

First, and I sincerely don't mean to be flippant or insensitive here, but I'm not sure most people should live by avoiding activities/products/services/etc. which the use of has a 1% chance of going wrong. If that were the case, we'd never be able to leave our house each day. For example, even though the odds are that you'll get into a car accident at least once in your life, people, for the most part, don't avoid cars. However, this may be a bit simplistic. There are ways to increase and decrease your chance of getting into that accident, and there is the severity of the accident, both of which are caused to some extent by factors completely under your control (e.g., are you wearing a seat belt, is the driver drunk, etc.) So ultimately, you have to make a decision about whether the chance of risk for whatever you're doing is possible or probable, and whether you actually need/want to do it (whether that's getting into a car, Botox, or whatever).

With the above stated, let's now turn to the stats that Allergen, the manufacturers of Botox, published. The most important thing to understand about them is that those stats include everyone who administers Botox: not only dermatologists, but also dentists, family practitioners, etc. This means that not everyone who is administering Botox actually has the required experience with facial skin, facial muscles, and injecting techniques. It's almost like the car accident. Get in the car with the wrong person and you're much more likely to get into an accident. As a result, the stats are skewed by these inexperienced people and thus you can extrapolate that from a qualified administer the chances of any side effects are much lower. While I can't tell you whether I'm the norm or not, I can share my own experience with side effects. Since Botox was released, I've completed somewhere around 6,000 injections, from which I've only seen six cases of side effects. These included droopy eyelids four times and muscle weakness in the neck twice. That's 0.1% of side effects.

Ultimately, there's risk in everything you do. You just have to decide where you want to take them. If the published numbers above (taken into context with my discussion) make you uncomfortable receiving Botox then you certainly shouldn't receive the treatment. Regardless, however, when you consider Botox, remember that Botox is not a "point and shoot" treatment. It takes judgement, knowledge of muscle anatomy and facial aging, and injector technique for micro injections. Thus, above all else, make sure that whoever is injecting you is qualified. Injectee beware.